Skip to main content

Advertisement

SpringerLink
Log in

The gut, vaginal, and urine microbiome in overactive bladder: a systematic review

  • Review Article
  • Published:
International Urogynecology Journal Aims and scope Submit manuscript

Abstract

Introduction and hypothesis

The objective was to systemically review the current literature on the association of gut, vaginal, and urinary dysbiosis in female patients with overactive bladder (OAB).

Methods

We performed a comprehensive literature search following the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) protocols for systematic reviews. In the EMBASE, CINAHL, and Medline databases, a search was conducted using key words such as “microbiome,” “microbiota,” “microflora,” “overactive bladder,” “urge,” “gut,” “vaginal.” Articles were screened using the online tool www.covidence.org. Two independent reviewers screened studies at each stage and resolved conflicts together. We excluded papers that discussed pediatric patients and animal studies. In total, 13 articles met this criterion, which included 6 abstracts.

Results

After identifying 817 unique references, 13 articles met the criteria for data extraction. Articles were published from 2017 to 2021. No study reported the same microbiota abundance, even in healthy individuals. Overall, there was a loss of bacterial diversity in OAB patients compared with controls. Additionally, the bacterial composition of the controls and OAB patients was not significantly different, especially if the urine was collected midstream. Overall, the composition of the microbiome is dependent on the specimen collection methodology, and the metagenomic sequencing technique utilized. OAB urine microbiome is more predisposed to alteration from the gut or vaginal influences than in controls.

Conclusions

Current evidence suggested a potential relationship among gut, vaginal, and urinary microbiome in OAB patients, but there are very limited studies.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

Abbreviations

BPH:

Benign prostatic hyperplasia

DO:

Detrusor overactivity

EQUC:

Enhanced quantitative urine culture

FMT:

Fecal microbiota transplantation

LUTS:

Lower urinary tract symptoms

MSU:

Midstream urine

OAB:

Overactive bladder

SCFAs:

Short-chain fatty acids

TUC:

Transurethral catheterized urine

UUI:

Urge urinary incontinence

References

  1. Onukwugha E, Zuckerman IH, McNally D, et al. The total economic burden of overactive bladder in the United States: a disease-specific approach. Am J Manag Care. 2009;15(4 Suppl):S90–7.

    PubMed  Google Scholar 

  2. Welk B, McArthur E. Increased risk of dementia among patients with overactive bladder treated with an anticholinergic medication compared to a beta-3 agonist: a population-based cohort study. BJU Int. 2020;126:183.

    Article  CAS  Google Scholar 

  3. Welk B, Richardson K, Panicker JN. The cognitive effect of anticholinergics for patients with overactive bladder. Nat Rev Urol. 2021;18:686–700.

    Article  CAS  Google Scholar 

  4. Peyronnet B, Mironska E, Chapple C, et al. A comprehensive review of overactive bladder pathophysiology: on the way to tailored treatment. Eur Urol. 2019;75:988.

    Article  Google Scholar 

  5. Hilt EE, Mckinley K, Pearce MM, et al. Urine is not sterile: use of enhanced urine culture techniques to detect resident bacterial flora in the adult female bladder. J Clin Microbiol. 2014;52:871.

    Article  Google Scholar 

  6. Curtiss N, Balachandran A, Krska L, et al. A case controlled study examining the bladder microbiome in women with overactive bladder (OAB) and healthy controls. Eur J Obstet Gynecol Reprod Biol. 2017;214:31.

    Article  Google Scholar 

  7. Ouma WZ, Mejia-Guerra MK, Yilmaz A, et al. Important biological information uncovered in previously unaligned reads from chromatin immunoprecipitation experiments (ChIP-Seq). Sci Rep. 2015;5:8635.

    Article  CAS  Google Scholar 

  8. Wu P, Chen Y, Zhao J, et al. Urinary microbiome and psychological factors in women with overactive bladder. Front Cell Infect Microbiol. 2017;7:488.

    Article  Google Scholar 

  9. Gill K, Kang R, Sathiananthamoorthy S, et al. A blinded observational cohort study of the microbiological ecology associated with pyuria and overactive bladder symptoms. Int Urogynecol J. 2018;29:1493.

    Article  Google Scholar 

  10. Magruder M, Edusei E, Zhang L, et al. Gut commensal microbiota and decreased risk for Enterobacteriaceae bacteriuria and urinary tract infection. Gut Microbes. 2020;12:1805281.

    Article  Google Scholar 

  11. Okamoto T, Hatakeyama S, Imai A, et al. Altered gut microbiome associated with overactive bladder and daily urinary urgency. World J Urol. 2021;39:847.

    Article  CAS  Google Scholar 

  12. Pearce MM, Hilt EE, Rosenfeld AB, et al. The female urinary microbiome: a comparison of women with and without urgency urinary incontinence. mBio. 2014;5:e01283.

    Article  CAS  Google Scholar 

  13. Ammitzboll N, Bau BPJ, Bundgaard-Nielsen C, et al. Pre- and postmenopausal women have different core urinary microbiota. Sci Rep. 2021;11:2212.

    Article  Google Scholar 

  14. Price TK, Hilt EE, Thomas-White K, et al. The urobiome of continent adult women: a cross-sectional study. BJOG. 2020;127:193.

    Article  CAS  Google Scholar 

  15. Cohn J, Brown ET, Guo Y, et al. MP31-03 the relationship between the urinary microbiome and central sensitization in women with overactive bladder. J Urol. 2017;197:e398.

    Google Scholar 

  16. Carabotti M, Scirocco A, Maselli MA, et al. The gut-brain axis: interactions between enteric microbiota, central and enteric nervous systems. Ann Gastroenterol. 2015;28:203.

    PubMed  PubMed Central  Google Scholar 

  17. Ackerman AL, Tang J, Eilber K, et al. MP82-02 decreased urinary fungal burden and diversity in overactive bladder. J Urol. 2017;197:e1097.

    Google Scholar 

  18. Ackerman AL, Tang J, Eilber K, et al. MP82-18 shared alterations in urinary bacterial communities in patients with interstitial cystitis and overactive bladder. J Urol. 2017;197:e1104.

    Google Scholar 

  19. Pohl HG, Groah SL, Perez-Losada M, et al. The urine microbiome of healthy men and women differs by urine collection method. Int Neurourol J. 2020;24:41.

    Article  Google Scholar 

  20. Dubourg G, Morand A, Mekhalif F, et al. Deciphering the urinary microbiota repertoire by culturomics reveals mostly anaerobic bacteria from the gut. Front Microbiol. 2020;11:513305.

    Article  Google Scholar 

  21. Tan J, McKenzie C, Potamitis M, et al. The role of short-chain fatty acids in health and disease. Adv Immunol. 2014;121:91.

    Article  CAS  Google Scholar 

  22. Thomas-White K, Taege S, Limeira R, et al. Vaginal estrogen therapy is associated with increased Lactobacillus in the urine of postmenopausal women with overactive bladder symptoms. Am J Obstet Gynecol. 2020;223:727.e1.

    Article  CAS  Google Scholar 

  23. Veit-Rubin N, Mahboobani KS, Cartwright R et al. Relationship between the urinary, urothelial and vaginal microbiome in overactive bladder: https://www.ics.org/2018/abstract/1. Accessed  28 Aug 2021

  24. Morand A, Cornu F, Dufour J-C et al. Human bacterial repertoire of the urinary tract: a potential paradigm shift. J Clin Microbiol. 2019;57:e00675-18.

    Article  Google Scholar 

  25. Xue LJ, Yang XZ, Tong Q, et al. Fecal microbiota transplantation therapy for Parkinson's disease: a preliminary study. Medicine (Baltimore). 2020;99:e22035.

    Article  Google Scholar 

  26. Madsen M, Kimer N, Bendtsen F, et al. Fecal microbiota transplantation in hepatic encephalopathy: a systematic review. Scand J Gastroenterol. 2021;56:560.

    Article  Google Scholar 

  27. Goloshchapov OV, Olekhnovich EI, Sidorenko SV, et al. Long-term impact of fecal transplantation in healthy volunteers. BMC Microbiol. 2019;19:312.

    Article  CAS  Google Scholar 

  28. Tariq R, Pardi DS, Tosh PK, et al. Fecal microbiota transplantation for recurrent Clostridium difficile infection reduces recurrent urinary tract infection frequency. Clin Infect Dis. 2017;65:1745.

    Article  CAS  Google Scholar 

  29. Ballenghien M, Faivre N, Galtier N. Patterns of cross-contamination in a multispecies population genomic project: detection, quantification, impact, and solutions. BMC Biol. 2017;15:25.

    Article  Google Scholar 

  30. Price TK, Wolff B, Halverson T, et al. Temporal dynamics of the adult female lower urinary tract microbiota. mBio. 2020;11:e00475-20.

    Article  Google Scholar 

  31. Haylen BT, de Ridder D, Freeman RM, et al. An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. Neurourol Urodyn. 2010;29:4.

    Article  Google Scholar 

  32. Wein AJ, Rovner ES. Definition and epidemiology of overactive bladder. Urology. 2002;60:7.

    Article  Google Scholar 

  33. Ugarcina Perovic S, Ksiezarek M, Rocha J, et al. Time to change microbiological approach to overactive bladder. Eur Urol Suppl. 2019;18:e103.

    Article  Google Scholar 

  34. Price T. A comparison of the female and male urinary microbiota in patients with and without lower urinary tract symptoms. 2017. 39th Annual American Urogynecologic Society (AUGS) Meeting, Providence, RI, USA.

Download references

Author information

Author notes

  1. Christina Sze and Mariel Pressler contributed equally to this work.

Authors and Affiliations

  1. Department of Urology, New York Presbyterian Hospital, New York, NY, USA

    Christina Sze

  2. New York Medical College, New York, NY, USA

    Mariel Pressler

  3. Division of Nephrology and Hypertension, Department of Medicine, Weill Cornell Medicine, New York, NY, USA

    John Richard Lee

  4. Department of Urology, Weill Cornell Medicine/New York Presbyterian Hospital, 525 E. 68th Street, New York, NY, 10021, USA

    Bilal Chughtai

Authors
  1. Christina Sze
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Mariel Pressler
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. John Richard Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Bilal Chughtai
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Study concept and design: Christina Sze, Mariel Pressler; acquisition of data: Christina Sze, Mariel Pressler; analysis and interpretation of data: none; drafting of the manuscript: Christina Sze, Mariel Pressler; critical revision of the manuscript for important intellectual content: Christina Sze, Mariel Pressler, John Richard Lee, Bilal Chughtai; supervision: Bilal Chughtai.

Corresponding author

Correspondence to Bilal Chughtai.

Ethics declarations

Conflicts of interest

Christina Sze: none; Mariel Pressler: none; John Richard Lee: holds patent US-2020-0048713-A1 entitled “Methods of Detecting Cell-Free DNA in Biological Samples” and receives research support under an investigator-initiated research grant from BioFire Diagnostics, LLC; Bilal Chughtai: consultant for Allergan and Boston Scientific.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary information

ESM 1

(DOCX 25 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Sze, C., Pressler, M., Lee, J.R. et al. The gut, vaginal, and urine microbiome in overactive bladder: a systematic review. Int Urogynecol J 33, 1157–1164 (2022). https://doi.org/10.1007/s00192-022-05127-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00192-022-05127-3

Keywords

Search

Navigation